Gordon H. Guyatt
@guyattgh.bsky.social
Promoting use of the best evidence and patient values and preferences to inform optimal clinical and health policy decisions.
Gordon Henry Guyatt is a Canadian physician who is a professor at McMaster University in Hamilton, Ontario. He is known for his leadership in evidence-based medicine, a term that first appeared in a single-author paper he published in 1991. Subsequently, a 1992 JAMA article led by Guyatt proved instrumental in bringing the concept of evidence-based medicine to the world's attention. Guyatt's concerns with the role of the medical system, social justice, and medical reform remain central issues that he promoted in tandem with his medical work. He was named to the Canadian Medical Hall of Fame in 2015. .. more
Economics
25%
Mathematics
24%
Physician interpretations and textbook definitions of blinding terminology in randomized controlled trials - PubMed
Our study suggests that both physicians and textbooks vary greatly in their interpretations and definitions of single, double, and triple blinding. Explicit statements about the blinding status of specific groups involved in RCTs should replace the current ambiguous terminology.
pubmed.ncbi.nlm.nih.gov
This @jama.com paper demonstrates that of the groups that could be blinded in #RCTs (patients, #clinicians, data collectors, adjudicators, #statisticians) if a study says only “double-blind” one can’t tell who is blind. Sadly, many #RCTs still fail to make explicit.
pubmed.ncbi.nlm.nih.gov/11308438/
pubmed.ncbi.nlm.nih.gov/11308438/
ROBUST-RCT: Risk of Bias instrument for use in Sys Tematic reviews for Randomised Controlled Trials
YouTube video by Teleducación Facultad de Medicina UdeA
www.youtube.com
Recent Cochrane collab Colombia Webinar: new #RiskofBias instrument for #RCTs, ROBUST-RCT @bmj.com publication this year. Talk shows how ROBUST-RCT maintains rigor while achieving user-friendliness and simplicity. Prediction: ROBUST will become the go-to #instrument.
www.youtube.com/watch?v=wFiS...
www.youtube.com/watch?v=wFiS...
GRADE guidelines: 20. Assessing the certainty of evidence in the importance of outcomes or values and preferences-inconsistency, imprecision, and other domains - PubMed
We provide guidance and examples for rating inconsistency, imprecision, and other domains for a body of evidence describing the relative importance of outcomes.
pubmed.ncbi.nlm.nih.gov
For anyone interested in the certainty/quality of evidence from studies of #Patient #ValuesAndPreferences, this #GRADE paper addressing #inconsistency, #imprecision and other domains is crucial.
pubmed.ncbi.nlm.nih.gov/29800687/
pubmed.ncbi.nlm.nih.gov/29800687/
Theory of clinical therapeutic progress: reconciling equipoise with fat-tailed (skewed) outcomes - PubMed
Medical progress relies on research that ultimately must rest, in part, on experimentation in randomized controlled trials (RCTs) involving human subjects. Researchers are ethically required to protect trial patients from being knowingly exposed to inferior treatments. This is achieved by requiring …
pubmed.ncbi.nlm.nih.gov
#RCT effects not normally distributed, follow a log-normal-Generalized Pareto Distribution. This doesn’t threaten underlying #equipoise, allows for discovery of large effects. Researchers conducting #Bayesian MA may consider using these priors.
pubmed.ncbi.nlm.nih.gov/41033405/
pubmed.ncbi.nlm.nih.gov/41033405/
Cost-Effectiveness of Pantoprazole for Upper GI Bleeding During Ventilation
This economic evaluation examines cost-effectiveness of daily intravenous pantoprazole vs no pantoprazole for preventing upper gastrointestinal bleeding in critically ill, mechanically ventilated pati...
jamanetwork.com
Just published big news for #IntensiveCare. #RandomizedTrial demonstrates that a #ProtonPumpInhibitor not only decreases gastrointestinal #bleeding, but because of #costs generated by those bleeds also appreciably decreases #ICU costs.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
GRADE guidelines 32: GRADE offers guidance on choosing targets of GRADE certainty of evidence ratings - PubMed
GRADE provides practical principles to help systematic review and health technology assessment authors specify the target of their certainty of evidence rating.
pubmed.ncbi.nlm.nih.gov
Gigantic #GRADE breakthrough in 2017: we rate certainty in whether a treatment effect lies on one side of a threshold or the other. But much clearer detailed guidance on choosing the target of the certainty rating was still needed. This article provides the guidance
pubmed.ncbi.nlm.nih.gov/33857619/
pubmed.ncbi.nlm.nih.gov/33857619/
GRADE approach to drawing conclusions from a network meta-analysis using a minimally contextualised framework - PubMed
GRADE approach to drawing conclusions from a network meta-analysis using a minimally contextualised framework
pubmed.ncbi.nlm.nih.gov
This #BMJ article, crucial for anyone conducting a #NetworkMetaAnalysis (NMA) and using #GRADE, provides the key approach to concluding what treatments work best, what are intermediate, and what are among the worst.
pubmed.ncbi.nlm.nih.gov/33177059/
pubmed.ncbi.nlm.nih.gov/33177059/
A Systematic Survey of the Optimal Strategy for Dealing With Missing Binary Outcomes in Simulation Studies of Randomized Controlled Trials - PubMed
Simulation studies address methods to deal with MBOD in RCTs, provided evidence that the MI approach is superior with respect to bias and coverage compared with CCA. Non-model-based single imputation generally performed poorly.
pubmed.ncbi.nlm.nih.gov
Recent simulation studies: how should #RCTs with binary outcomes address #MissingData? Multiple imputation best, single imputation, complete case less well. Data missing not at random, typical situation, nothing works well. Missing data risks #bias, too bad.
pubmed.ncbi.nlm.nih.gov/40856174/
pubmed.ncbi.nlm.nih.gov/40856174/
A clinician's guide for conducting randomized trials in individual patients - PubMed
In determining optimal treatment for a patient conventional trials of therapy are susceptible to bias. Large-scale randomized trials can provide only a partial guide and have not been or cannot be carried out for most clinical disorders. However, randomized controlled trials (RCTs) in individual pat …
pubmed.ncbi.nlm.nih.gov
#RandomizedTrials in individual patients – #Nof1 #RCTs – provide the highest certainty evidence of treatment impact in an individual. The epitome of best clinical practice. This article gives a step by step for setting up and running an N of 1 trial.
pubmed.ncbi.nlm.nih.gov/3409138/
pubmed.ncbi.nlm.nih.gov/3409138/
Reposted by Thomas Agoritsas
https://www.clarityresearch.ca/frequently-asked-questions
t.co
Core #GRADE, 7 articles in #BMJ this spring, one-stop-shopping for those who want to get GRADE right with the essentials. Now also frequently asked question – latest post considers a priori hypotheses to explain #heterogeneity. All questions welcome, send to guyatt@mcmaster.ca
t.co/hh6owWxn5O
t.co/hh6owWxn5O
Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis - PubMed
The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value- and preference-dependent, suggesting a change in practice towards shared decision-making is necessary.
pubmed.ncbi.nlm.nih.gov
This #SystematicReview and #MetaAnalysis shook up the surgical world when results suggested that #antibiotics rather than #surgery may, for many patients, be the best management for their #appendicitis.
pubmed.ncbi.nlm.nih.gov/26990957/
pubmed.ncbi.nlm.nih.gov/26990957/
The GRADE approach and Bradford Hill's criteria for causation - PubMed
This article describes how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to grading the quality of evidence and strength of recommendations considers the Bradford Hill criteria for causation and how GRADE may relate to questions in public health. A primary co …
pubmed.ncbi.nlm.nih.gov
#BradfordHill’s iconic criteria for addressing #causation still resonates with many. How do those criteria relate to #GRADE’s certainty of evidence for causation? This paper explains.
pubmed.ncbi.nlm.nih.gov/20947872/
pubmed.ncbi.nlm.nih.gov/20947872/
Just back from a trip to #Chengdu, the birthplace of #EBM, where applying EBM to #TraditionalChineseMedicine and thus advance #TCM on the global stage is all the rage. With my first Chinese Phd student Xin Sun, now number 1 in EBM in China, and his colleagues.
Gordon H. Guyatt
@guyattgh.bsky.social
· Nov 24
#evidence #ebm #medicine | Gordon Guyatt
In this one minute video I explain how a person who takes an #Evidence based approach to life responds when asked a question for which they don’t know the evidence.
#EBM #medicine
www.linkedin.com
In this one minute video I explain how a person who takes an #Evidence based approach to life responds when asked a question for which they don’t know the evidence.
@leticiakawano.bsky.social
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@leticiakawano.bsky.social
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